Client's Details
Definition of a Birth Doula
A Birth Doula is a non-medical assistant during pregnancy, birth and
immediate postpartum. She supports a woman during her pregnancy (both
virtually and in person), attends the birth in person whether the Client
births at home or hospital, with an OB or midwife.
Services of a Birth Doula
A Birth Doula works with each family individually and tends to their
particular needs. Some of the services that a Doula will perform may
include:
- Prenatal education
- Preparation for childbirth
- Pain coping techniques
- Relays information regarding pregnancy, birth and postpartum
- Breastfeeding support
- Helps with the emotional and physical recovery after birth
- Referrals to local resources
Package
The Birth Doula Package includes the following:
- Two in-person prenatal visits (approximately 1.5 hours each)
- Online support for duration of pregnancy
- On-call support from 37 weeks
- In person support for labour, birth and immediate postpartum
- One in-person postpartum visit (approximately two hours)
Limitation of Services Provided by Ummah Maternal and Doulas
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Ummah Maternal and Doulas shall not replace a licensed medical provider.
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Ummah Maternal and Doulas shall not perform clinical tasks, such as taking
blood pressure, fetal heart checks, or vaginal exams.
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Ummah Maternal and Doulas do not attend medical appointments or
hospital/triage visits with clients.
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Ummah Maternal and Doulas do not make decisions for Client or provide
medical advice. They will direct Client to resources that might help
Client make informed decisions.
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Ummah Maternal and Doulas are not responsible for the outcomes of Client's
birth.
Confidentiality
All personal information collected by Ummah Maternal and Doula from Client are
only used with the intention of meeting Client's service needs, to process
payment for services attained, and to inform Client of relevant services. All
information shared by Client will be kept strictly confidential, except when
releasing such information is required by law. Ummah Maternal and Doula shall
not give personal information to any third party.
Failure to Provide
If failure to attend the birth is due to doula's error, partial refund will
be provided. If failure to attend the birth is due to a rapid labour,
Client's failure to call Doula, hospital policies, voluntary termination of
this contract, weather or anything else out of control of Doula, full fee
will still apply and there will be no refunds. However, additional
postpartum services in lieu of monetary reimbursement will be offered. It is
important that the Client calls the Doula instead of texting / messaging if
the matter is urgent. In the event of an emergency c-section, full fees
still apply as doula support will still be given before, during and after
labour.
Disputes
If Client has any concerns or complaints about the Doula that has been
hired, Ummah Maternal should be informed immediately via email. Ummah
Maternal will attend to the matter in an attempt to satisfy the Client and
provide meditation between Doula and Client.
Back-up Doula
Doula reserves the right to call in a backup doula if she is unable to
attend birth, labour surpasses 24 hours, or if she is extremely exhausted.
In the event a back-up doula attends the birth, Client will not pay
additional fees. Doula will ensure backup doula receives funds allocated for
the services rendered. Client may meet backup doula virtually prior to the
due date so that both parties are familiar with one another.
Liability Waiver
In entering a contract for Doula Birth Services, I hereby acknowledge that
during the performance period of this contract, services may be provided to
me in my home, traveling to a medical facility, and/or hospital. I
understand that the birth doula has a limited role pursuant to the
description of tasks outlined in the above-referenced contract wherever
services are provided to me.
The Doula has not represented to me that contracting for services guarantees
in any way a risk-free or emergency-free labour and birth experience. I
understand that my doula(s) does not make medical decisions on my behalf, to
include the decision when to seek medical care at a hospital when labour
support services are provided in my home.
When services are performed in a medical facility, I acknowledge that the
Doula is not responsible for the performance of clinical tasks to include
medical decisions regarding the inclusion or exclusion of treatments
available to me and my baby.
Now, therefore, in consideration of the above acknowledgements, I on behalf
of myself, my heirs, administrators, personal representatives, executors,
and assigns to RELEASE AND FOREVER DISCHARGE the doula from all damages or
causes of actions, either at law or in equity, which I may have or acquire
or which may accrue to me, my heirs, administrators, personal
representatives, executors or assigns as a result of using the doula
services from Ummah Maternal Services. I intend this to be a COMPLETE
RELEASE AND DISCHARGE from all liability whatsoever.
I have read all statements contained herein and I fully realize that I am
signing a COMPLETE RELEASE AND BAR to any claims which I have or believe I
have resulted from our contract for doula services.
Fee
Birth Doula Service fee structure is as follows:
- $712.50 +HST due upon signing of contract
- $712.50 +HST due by 35 weeks on
If a client is signing the contract after 35 weeks pregnant, they must pay
the full $ 1425 +HST upon signing of the contract.
Note:
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Additional prenatal and postpartum sessions are available upon request at
additional fee
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Additional travel costs outside a
30-kilometer catchment area may be incurred. This cost is
based on Canada Revenue Agency's expense allowance for mileage for the
year in which the travel occurred. The CRA rate for 2024 is
$0.70/km. Doula will invoice Client directly for mileage.
Client pays mileage fees to Doula via payment method agreed upon.
Signatures